This renewal grant application proposes continued support for the evaluation component of Seattle's Prepaid Health Care Project. The Prepaid Project offers a prepayment plan with very comprehensive full- service benefits to a low-income urban population. A choice is offered between two delivery systems: a large prepaid group practice and the independent fee-for-service physicians and hospitals of Seattle. The evaluation of this federally funded demonstration is being conducted by a consortium comprised of representatives from the Project, providers, and a University of Washington faculty group. The evaluation is designed: to determine the health benefits accruing to enrollees and the longer range effects on former enrollees; to compare the health care received from the prepaid group practice and the independent fee-for-service physicians and hospitals with respect to utilization, costs, quality of care, access and acceptability; and to provide management information to the Prepaid Project. The analysis will be conducted on the basis of data derived from household interview surveys and annual resurveys of enrollees and former enrollees; claims data; and extensive abstracting and reconstructing from medical records in physicians' offices and hospitals.